Rate of smokeless tobacco use in U.S. unchanged: CDC

NEW YORK (Reuters Health) - While the portion of U.S.
working adults smoking tobacco shrank appreciably between 2005
and 2010, the use of smokeless tobacco remained steady,
according to a new study.

In 2005, 2.7 percent of working adults represented in the
annual National Health Interview Survey used smokeless tobacco
and in 2010, it was 3 percent. That's still about 10 times
higher than national public health policy goals, researchers
said.

"These findings highlight opportunities for reducing the
health and economic burdens of tobacco use among U.S. workers,
especially those in certain industries (e.g., mining) and
occupations (e.g., construction and extraction) where use of
smokeless tobacco is especially common," the report's authors
write.

Dr. Jacek Mazurek, of the Division of Respiratory Disease
Studies, National Institute for Occupational Safety and Health
at the Centers for Disease Control and Prevention (CDC), led the
study that was published in the CDC's Morbidity and Mortality
Weekly Report.

The researchers analyzed data on some 30,000 working adults
collected in both 2005 and 2010. Survey participants answered
questions about their jobs and their use of smokeless tobacco
products such as snus and chewing tobacco, as well as their use
of cigarettes.

Smokeless tobacco use was highest in certain industries and
regions, the study team found. In mining, about 19 percent of
workers used smokeless tobacco. About 9 percent of people
employed in wholesale trades and 8 percent of construction
workers were smokeless tobacco users as well.

Among demographic groups, smokeless tobacco use was highest
among white males ages 25 to 44 years old, people with no more
than a high school education and those living in the Midwest and
the South.

The study also found that about 4 percent of working adults
who smoked cigarettes also used smokeless tobacco.

In contrast with smokeless tobacco use, tobacco smoking
rates fell among working adults from 22.1 percent in 2005 to
19.1 percent in 2010, the study team points out.

"The lack of reduction in smokeless tobacco use might be
attributable to the introduction of novel smokeless tobacco
products into the U.S. marketplace (e.g., snus and dissolvable
tobacco), as well as increased expenditures on smokeless tobacco
marketing in recent years," the authors write in their report.

Lucy Popova, from the Center for Tobacco Control Research
and Education at the University of California, San Francisco
called the new study very timely.

"Cigarettes have been at the forefront of attention because
they are the most harmful and the most deadly product out there,
but there's been a lot of efforts in the public health
community, and cigarette smoking rates are going down, but we
don't see equal reduction in smokeless tobacco" Popova told
Reuters Health.

Popova, who was not involved in the new study, said that a
tobacco prevention program from the U.S. Food and Drug
Administration called The Real Cost Campaign, plans to add a
specific program targeted at smokeless tobacco use.

The risks of smokeless tobacco include problems such as
receding gums, loss of bones around the teeth, precancerous
lesions, and cancers of the mouth, esophagus and pancreas,
Popova said.

"The use of smokeless tobacco is also a risk factor in high
blood pressure and cardiovascular disease and of course
smokeless tobacco is addictive," she said.

Popova highlighted a new finding in the report, that the
average number of cigarettes smoked per day was significantly
higher among dual users compared to those who used cigarettes
only.

"People would expect that if you use two types of tobacco
you'd smoke less - you would substitute and so you would reduce
your harm, but what we see here is that people who are dual
users actually smoke more," she said.

But this makes sense, she said, because dual users become
more dependent on tobacco and want a higher dose of nicotine.

The report's authors note that past research indicates
smokers may switch to smokeless tobacco because they think it's
safer than smoking, but it's not and no evidence suggests it
helps smokers transition to quitting.

They urge employers to make workplaces tobacco free and to
offer tobacco-cessation support, and encourage healthcare
providers and government to spread the message and fund
tobacco-control programs.